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A case report of successful diagnosis of a pulmonary nodule by a survey of oncogenic mutations; primary lung carcinoma or pulmonary metastasis?

View Article: PubMed Central - PubMed

ABSTRACT

It is very difficult to make a differential diagnosis between primary and metastatic lung carcinoma.

The NRAS mutation is detected in several tumors, but the sites and the amino changes of NRAS mutaion is various.

Examination of oncogenic mutation is a useful in the diagnosis of pulmonary tumors.

Examination of oncogenic mutation is a useful in the diagnosis of pulmonary tumors.

No MeSH data available.


Related in: MedlinePlus

Panel A: Colonoscopy revealed a bowel hemorrhage from the colorectal carcinoma. Panel B: Hematoxylin-eosin stain showed well-to-moderately differentiated tubular adenocarcinoma. (×200).
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fig0005: Panel A: Colonoscopy revealed a bowel hemorrhage from the colorectal carcinoma. Panel B: Hematoxylin-eosin stain showed well-to-moderately differentiated tubular adenocarcinoma. (×200).

Mentions: A 64-years-old man presented with dyspnea. He had acute cardiac insufficiency, and chest X-ray and chest CT showed cardiac dilatation and a right side pulmonary tumor with right mediastinal and hilar lymphadenopathy and bilateral pleural effusion. Following his recovery from the acute cardiac insufficiency, he suffered from a sudden bowel hemorrhaged due to colorectal carcinoma (Fig. 1). The hemorrhage was locally controlled using radiation therapy (40 Gy/16 Fr) combined with oral S-1. After recovery from the heart failure and bowel hemorrhage, chest CT revealed that the size of the pulmonary tumor had increased in size to 10.4 cm (Fig. 2). A tissue biopsy of the pulmonary tumor was performed via bronchoscopy (Fig. 3A). The histological diagnosis was poorly differentiated adenocarcinoma (Fig. 3B). We could not make a differential diagnosis between primary lung carcinoma and metastatic lung tumor from colorectal carcinoma because both TTF-1 and CK20 were immunohistologically negative (Fig. 3C and D). As such, chemotherapy of carboplatin and irinotecan was given to the patient as irinotecan is effective for both primary lung carcinoma and colorectal carcinoma.


A case report of successful diagnosis of a pulmonary nodule by a survey of oncogenic mutations; primary lung carcinoma or pulmonary metastasis?
Panel A: Colonoscopy revealed a bowel hemorrhage from the colorectal carcinoma. Panel B: Hematoxylin-eosin stain showed well-to-moderately differentiated tubular adenocarcinoma. (×200).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120262&req=5

fig0005: Panel A: Colonoscopy revealed a bowel hemorrhage from the colorectal carcinoma. Panel B: Hematoxylin-eosin stain showed well-to-moderately differentiated tubular adenocarcinoma. (×200).
Mentions: A 64-years-old man presented with dyspnea. He had acute cardiac insufficiency, and chest X-ray and chest CT showed cardiac dilatation and a right side pulmonary tumor with right mediastinal and hilar lymphadenopathy and bilateral pleural effusion. Following his recovery from the acute cardiac insufficiency, he suffered from a sudden bowel hemorrhaged due to colorectal carcinoma (Fig. 1). The hemorrhage was locally controlled using radiation therapy (40 Gy/16 Fr) combined with oral S-1. After recovery from the heart failure and bowel hemorrhage, chest CT revealed that the size of the pulmonary tumor had increased in size to 10.4 cm (Fig. 2). A tissue biopsy of the pulmonary tumor was performed via bronchoscopy (Fig. 3A). The histological diagnosis was poorly differentiated adenocarcinoma (Fig. 3B). We could not make a differential diagnosis between primary lung carcinoma and metastatic lung tumor from colorectal carcinoma because both TTF-1 and CK20 were immunohistologically negative (Fig. 3C and D). As such, chemotherapy of carboplatin and irinotecan was given to the patient as irinotecan is effective for both primary lung carcinoma and colorectal carcinoma.

View Article: PubMed Central - PubMed

ABSTRACT

It is very difficult to make a differential diagnosis between primary and metastatic lung carcinoma.

The NRAS mutation is detected in several tumors, but the sites and the amino changes of NRAS mutaion is various.

Examination of oncogenic mutation is a useful in the diagnosis of pulmonary tumors.

Examination of oncogenic mutation is a useful in the diagnosis of pulmonary tumors.

No MeSH data available.


Related in: MedlinePlus